causes—most notably tobacco use, obesity, physical inactivity and
failure to use or comply with interventions that treat or prevent
infectious causes of cancer. These facts underscore the need for
continued research to inform effective public educational
campaigns and programs that can encourage and help people
change their behaviors.

Population-based screening programs have been credited with
dramatically increasing the five-year survival rates for the cancers
that they detect because finding a tumor early makes it more likely
that it can be treated successfully and with fewer side effects.
There is concern, however, that this heightened surveillance can
lead to overdiagnosis and overtreatment, potentially causing more
harm than good. More research to address these problems is vital
to ensure that the public has confidence in current screening
guidelines and in any future recommendations that may be made.
In addition, we need to develop screening strategies for those
cancers that we cannot detect early, in particular, those that
currently elude detection until they are at an advanced stage.

Making Research Count for Patients

Decades of research have provided an understanding of the
fundamental nature of cancer, and why and how cancer develops
and spreads throughout the body. These major discoveries about
the biology of cancer are beginning to be translated into new
breakthrough therapies that are being used alongside the
traditional triad of cancer patient care—surgery, radiotherapy and
chemotherapy—to transform the treatment of patients with certain
forms of cancer. In the past 12 months alone (September 2011
through the end of August 2012), the Food and Drug Administration
(FDA) U.S. approved eight new drugs for the treatment of cancer,
one new drug for the treatment of precancerous lesions, as well as
new uses for three previously approved drugs, increasing the
number of patients benefiting from these therapies. There are also
numerous ongoing clinical trials testing other agents, several of
which are showing promise for near-term clinical advances.

The majority of the cancer therapies approved by the FDA in the
past 12 months are more effective and less toxic than older
treatments that have been the mainstay of patient care. As a result,
these new therapies are not only saving the lives of countless
American Association for Cancer Research

cancer patients, but are also improving their quality of life. Rapid
advances in this area are likely in the near future, as we learn more
about patient characteristics that predict their response to a certain
therapy. Patients identified as likely to respond will receive
treatment, while those determined to be very unlikely to respond
will be spared any adverse side effects from the course of therapy.
Moreover, definitive stratification of patient populations can also
provide healthcare savings by avoiding the futile use of ineffective
courses of cancer treatments and the treatment costs associated
with their adverse effects.

Unfortunately, progress has not been uniform for all forms of
cancer, and this highlights the great need for continued cancer
research. Large-scale analyses of the genetic underpinnings of
cancer are now guiding the development of new cancer drugs and
are directing the repurposing of proven therapies to treat novel
cancer types. Further innovation is needed, however, if
genetic/genomic analysis is to become part of standard practice,
and if most cancer treatment and prevention strategies are to be
based on both a person’s genetic makeup and the genetic makeup
of their specific cancer.

While the altered genomes of cancer cells can have a profound
effect on the development and spread of cancer, factors at all
levels—from molecules to cells to humans—are involved.
Understanding all of these influences will help to determine which
can be exploited to most significantly impact patient care. In
addition, it is vital that we learn not only how these factors work in
isolation, but also how they affect each other. While progress is
beginning to be made in several areas, it will take a concerted
effort from all in the cancer research community to deliver future
breakthroughs.

What is Required for ContinuedProgress Against Cancer?

Congressional support for the NIH and NCI has enabled
extraordinary progress against cancer, and in doing so has saved
countless lives while catalyzing the development of the
biotechnology industry and economic growth in America. The
research-fueled explosion of both knowledge and technological
innovation, as well as our ever-increasing understanding of how to